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Streptobacillus moniliformis endocarditis: case report and review
1Department of Internal Medicine, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0049.
Summary
Rat-bite fever caused by Streptobacillus moniliformis can lead to endocarditis and septic arthritis, even without a rash. Penicillin therapy is typically effective for this rare but serious infection.
Area of Science:
- Infectious Diseases
- Cardiology
- Rheumatology
Background:
- Rat-bite fever, caused by Streptobacillus moniliformis, is a rare zoonotic infection.
- Endocarditis is a serious complication, often associated with pre-existing heart valve damage, typically from rheumatic heart disease.
- Septic arthritis can also occur, with unusual joint involvement reported.
Observation:
- A case of a 46-year-old man with rat-bite fever complicated by endocarditis and septic arthritis involving the sternoclavicular joint is presented.
- This case notably lacked the typical rash associated with rat-bite fever.
- Previous literature describes sixteen cases of streptobacillary endocarditis.
Findings:
- Echocardiography revealed valvular vegetations in two of four examined cases.
- Embolic phenomena were rare in the reported cases.
- Adequate penicillin dosage was curative in this case.
Implications:
- This case highlights the diverse clinical presentations of rat-bite fever, including endocarditis and septic arthritis.
- Early diagnosis and appropriate antibiotic treatment, such as penicillin, are crucial for favorable outcomes.
- Further research may elucidate the specific factors contributing to severe complications like endocarditis in Streptobacillus moniliformis infections.